10 CMS and FDA Actions Affecting Care in 2026 - Report - MDSpire

10 CMS and FDA Actions Affecting Care in 2026

From Medicare payment updates to drug approvals and device access, these federal actions may affect reimbursement, prescribing, patient access, and clinical workflows.

  • By

  • Conexiant News Staff

  • July 10, 2026

  • 7 min

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Clinical Report: 10 CMS and FDA Actions Affecting Care in 2026

Background

Understanding the evolving landscape of healthcare regulations is crucial for healthcare professionals to ensure compliance and optimize patient care. The actions taken by CMS and FDA can influence reimbursement structures, prescribing practices, and patient access to necessary treatments.

Data Highlights

No numerical data provided in the source material.

Key Findings

  • 2026 Medicare Physician Fee Schedule final rule establishes separate conversion factors for qualifying and non-qualifying APM participants.
  • Changes to Medicare Advantage and Part D include elimination of cost-sharing for adult vaccines and insulin products.
  • Updates to outpatient and ASC payment policies include a 2.6% increase in payment rates for hospitals and ASCs meeting quality reporting requirements.
  • CMS finalized electronic prior authorization capabilities to reduce administrative burdens for providers.
  • FDA approved Foundayo for weight management in adults with obesity or overweight and related comorbidities.
  • Proposed rule for electronic prior authorization for drugs aims to enhance transparency and efficiency in the prior authorization process.

Clinical Implications

Healthcare providers should prepare for changes in reimbursement policies and ensure compliance with new electronic prior authorization requirements.

Conclusion

The actions by CMS and FDA in 2026 will impact healthcare policy and require adjustments by healthcare providers.

Related Resources & Content

  1. CMS, CMS, 2025 -- Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule
  2. FDA, FDA, 2024 -- FDA Approves First Medication for Obstructive Sleep Apnea
  3. FDA, FDA, 2025 -- FDA Approves Under-the-Skin Form of Drug for Maintenance Treatment of Alzheimer’s Disease
  4. ophthalmic professional — Two Important Compliance Updates for 2025
  5. The ASCO Post — Three Models Testing Ways to Lower Drug Costs Outlined in Health and Human Services Report
  6. ophthalmology management — Coding & Compliance: 2025 Updates Impacting Ambulatory Surgery Centers
  7. Ophthalmology Management — 2026 Coding Updates Impacting Ambulatory Surgical Centers
  8. Two Important Compliance Updates for 2025
  9. Three Models Testing Ways to Lower Drug Costs Outlined in Health and Human Services Report
  10. Coding & Compliance: 2025 Updates Impacting Ambulatory Surgery Centers
  11. 2026 Coding Updates Impacting Ambulatory Surgical Centers
  12. Calendar Year (CY) 2026 Medicare Physician Fee Schedule Final Rule (CMS-1832-F) | CMS
  13. FDA Approves First Medication for Obstructive Sleep Apnea | FDA
  14. FDA Approves Under-the-Skin Form of Drug for Maintenance Treatment of Alzheimer’s Disease

Original Source(s)

10 CMS and FDA Actions Affecting Care in 2026

  • by Conexiant News Staff

  • July 10, 2026

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